Integrated Yoga Therapy for teaching Toothbrushing skills | Children with ASD

By Prapoorna M

Last Updated: November 27, 2021

Children with autism spectrum disorder (ASD) exhibit poor oral health due to lack of manual dexterity. Regular training methods such as visual pedagogy and video modeling (VM) for developing the skill of toothbrushing do not address the core deficits which facilitate their effective and quick learning.

Hence, there arises the need of an integrated therapy which can complement these regular training techniques. Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder which is characterized by social impairment, communication impairment, and stereotyped repetitive activities.

There are no known autism-specific oral manifestations, and the oral problems that arise are due to their autism-related behaviors. In general, these children exhibit poor oral health with plaque and calculus accumulation, which is attributed to the tactile defensiveness against toothbrushing and the use of other intraoral hygiene devices.

Child brushing her teeth
Child brushing her teeth

Visual pedagogy (VP) and video modeling (VM) are some of the effective evidence-based methods to train children with ASD who are considered as good visual learners. While the above methods work efficiently on the relative strengths of children with ASD, they do not address the core deficits of the disorder.

Yoga is a powerful and promising tool in these children to improve the coordination of activities of mind, body, and emotions. It not only improves their focus and concentration, which is lacking in children with ASD , but also shown to improve the imitation skills, gross motor skill, and attention, which are essential prerequisites for learning.

In the yoga techniques practiced by the children, the warm-up practices were given to help improve flexibility, create awareness, and enhance energy circulation throughout the body. Asanas are psychophysiological practices that form the basis of mind–body integration activity which also stretches the musculature, loosens the stiff joints, promotes better circulation, and enhances mobility and range of motion. Physical functioning becomes more integrated and less stressful, enabling the child to become aware, more focused, and remain organized.

Pranayama alleviates stress and enhances memory and comprehension. The combination of asanas and pranayama enhances and balances various physiological functioning, helping to reduce emotional blockages and negative habitual patterns that can obstruct the flow of vital energy within the mind–body complex.

Helpful Asanas

Asanas such as Ardhakatichakrasana and Meru asana, included in our schedule, stimulate the vestibular and proprioceptive systems and increase strength and coordination. These asanas also keep hyperactivity in check , increase blood flow to the brain, and activate and rejuvenate brain cells, thereby promoting dexterity, mental health, creativity, concentration, and memory.

Girl doing yoga
Girl doing yoga

Pawanmuktasana soothes the nervous system and thereby calms the mind. It also increases blood supply to the brain and improves concentration. The practice of pranayama augments stamina, mental balance, and strength and induces better sleep by the improved circulation of vital energy. It helps to harness energy, thereby reducing hyperactivity, resulting in improved attention and focus. A complete relaxation resulting in a calm state of mind is achieved in children with ASD, with integrated approach to yoga therapy.

Improvements in sensory integration and attention and increased verbal receptivity for commands were also observed children were able to perform “inserting pegs task,” indicating improved fine motor skills such as eye–hand coordination and grip strength following pranayama training reported the effect of MukhaBhastrika on reaction time in mentally challenged individuals (Ramanathan, Eswari, Bhavanani, Prathima, and Sanguida, 2019), and recently, Ramanathan et al. (2019) reported reduced reaction time in children with ASD following yoga training (Bhavanani et al., 2012).

This reduced reaction time signifies an improved sensory motor performance, greater arousal, faster rate of information processing, and improved concentration (Bhavanani et al., 2012; Ramanathan et al., 2019). Radhakrishna (2010) concluded that the integrated yoga therapy module to children with ASD improved imitation skills (Radhakrishna, 2010).

The children with ASD who underwent training with VP and VM along with concurrent yoga training were able to learn the toothbrushing skill more effectively and quickly when compared to the children who were trained by the regular methods alone. Therefore, it can be concluded that yoga has a positive and additive role as an adjunct along with the regular training methods of VP and VM.

Yoga training provides a platform for easier training of self-help skills such as toothbrushing habit.